The Puget Sound Blood Center is a regional full-service facility (laboratory, education, research, consultation, and training) committed to advancing research in transfusion medicine. It has the resources to provide basic support for a broad range of research endeavors and the operational mechanisms to ensure the transfer of research results into changes in resource management, product preparation, transfusion therapy, patient care; donor recruitment, donor guidelines, basic education, and training. Using a cadre of Blood Center staff physicians and collaborative arrangements with investigators at the Fred Hutchinson Cancer Research Center, Virginia Mason Research Center, and the University of Washington School of Medicine, this proposed NRDC will explore problems in transfusion and transplantation medicine on several levels, from basic investigations to practical application. Furthermore, it seeks to expand the traditional role of a blood center (providing only products obtained from donated whole blood) into recruitment of compatible donors for bone marrow transplantation and identifying those immunogenic factors that influence the outcome of unrelated bone marrow grafting and related kidney transplants. The specific areas to be explored are: 1) physiologic and pathologic factors that influence the response to transfused platelets; 2) analysis of immunologic changes in renal transplant recipients following blood transfusion -- study of donor-specific transfusions (DST); and 3) development of unrelated bone marrow transplantation. The Demonstration and Education projects will focus on defining the altruistic behavior of donors and how this can be used to identify committed donors for special requirements (plateletpheresis and bone marrow donations); education of donors to these special requirements; integration of new technology into routine blood banking practice; and blood bank resource management to provide optimal products in a cost-effective manner. A group of experts in transfusion medicine, education, psychology, computer programming, and cost-effective technology assessment will endeavor to: 1) determine optimum platelet provision by a community blood center; 2) establish an unrelated volunteer bone marrow donor program; and 3) determine if routine blood donation can be accomplished by pheresis technology.